Attributes and Barriers to Care of Pelvic Pain in University Women

Abstract

Study Objective To describe rates of pelvic pain in university women ages 18 and older and to explore the barriers to adequate health care for pelvic pain in this population. Design A cross-sectional study (Canadian Task Force classification II-2). Setting University of Florida, Gainesville, FL. Patients A total of 2000 female students at the University of Florida were randomly selected for participation. Interventions The 2000 sample members were sent a questionnaire to be completed online. Measurements and Main Results The online questionnaire was hosted through the REDCap electronic data capture tool hosted at the University of Florida. This questionnaire included demographic items, general health and health behavior questions, measures to assess different types of pelvic pain (e.g., dysmenorrheal; dyspareunia; urinary, bowel, and vulvar pain), items regarding barriers to care for pelvic pain problems, and quality of life measures. Data were exported to SAS software (SAS Institute Inc., Cary, NC) for analysis. Of the 2000 subjects who received the questionnaire invitation, 390 filled out the questionnaire, yielding a response rate of 19.5%. Respondents’ ages ranged from 18 to 62 with a mean of 23 years. A total of 72.8% of respondents reported experiencing pelvic pain over the past 12 months. Dysmenorrhea was reported by nearly 80% of participants, over one third of participants noted deep dyspareunia, and a significant proportion of participants reported symptoms related to bowel movements. Vulvar symptoms, including superficial dyspareunia, were reported by 21.5% of participants. Most participants with pelvic pain (78.8%) have not received any diagnosis for their pain, whereas 73.6% reported not yet having visited a doctor. Significant barriers to receiving adequate medical care were reported, including difficulty with insurance coverage and physicians’ lack of time and knowledge or interest in chronic pelvic pain conditions. Conclusion Pelvic pain in younger women is a critical public health issue experienced by a significant portion of the population. Significant awareness deficits and barriers to care exist. Careful study of the barriers to receiving adequate medical care reported by these women will allow researchers to describe how best to improve care for these syndromes.

Urogenital and pelvic complications in the Ehlers‐Danlos syndromes and associated hypermobility spectrum disorders: A scoping review

“…One prior review of pain in EDS also noted the occurrence of vulvodynia and dyspareunia. Previous research has found that less than a third of women with pelvic pain report it to a medical provider, thus the already high rates found in this review may underrepresent this problem.…”

Gynaecological care of women with chronic pelvic pain: Patient perspectives and care preferences

“…ACOG describes traumatic events as experiences ranging from sexual abuse to natural disasters or encounters with the healthcare system 6 . Previous studies have identified that sexual trauma and abuse are associated with chronic pelvic pain, and that there are many barriers to women seeking pelvic pain care 3,7,13–17 . However, the responses of clinicians and healthcare systems to patients with chronic pelvic pain in the aftermath of negative experiences and trauma are poorly understood.…”

“…Previous cross‐sectional work demonstrated barriers in accessing pelvic pain care, and recommended deeper exploration into different subtypes of pelvic pain 7 . In an effort to improve outcomes for patients with non‐menstrual chronic pelvic pain, we conducted focus groups to better understand barriers and identify patient‐centred solutions.…”

“…Previous cross-sectional work demonstrated barriers in accessing pelvic pain care, and recommended deeper exploration into different subtypes of pelvic pain. 7 In an effort to improve outcomes for patients with non-menstrual chronic pelvic pain, we conducted focus groups to better understand barriers and identify patient-centred solutions. We focused on institutional betrayal, a concept in the field of social sciences that describes how the actions and inactions of an institution can have a significant impact on response and recovery.…”

The Relationship of Older Adults' Physical Pain to Depression and Post-Traumatic Stress Disorder (PTSD): A Review

“…Moreover, although a review of the factors that serve as barriers to proper medical and pain care is beyond the scope of this article, it is important to address them briefly. They include having health insurance problems [17], lower educational levels [18], as well as an ethnic minority background and low socio-economic status [19]. Furthermore, an under-investigated yet important potential risk factor for pain is perceived racial discrimination, which has been related to higher pain reports of older African-American male veterans [20].…”